By Alicia Doyle

The Writer
Specializing in Good News
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Prostate Cancer: Cause and Cure


Your Health Connection Magazine
June 2009


THE SECOND LEADING CAUSE OF CANCER DEATH IN MEN IN THE UNITED STATES — WITH AN IMPACT ROUGHLY EQUIVALENT TO THE EFFECTS OF BREAST CANCER ON WOMEN — PROSTATE CANCER IS BECOMING AN INCREASINGLY IMPORTANT PUBLIC HEALTH CONCERN.

“PROSTATE CANCER IS THE MOST COMMON CANCER, other than skin cancers, in American men,” said Duke K. Bahn, medical director of the Prostate Institute of America at Community Memorial Hospital in Ventura, California.

In fact, the American Cancer Society estimates that during 2008, about 186,320 new cases of prostate cancer were diagnosed in the United States.

“About one man in six will be diagnosed with prostate cancer during his lifetime, but only one man in 35 will die of it,” continued Bahn, noting that this cancer is the most common in men over age 60. “It is estimated that we have lost 28,660 men in 2008.”

In spite of these alarming statistics, many men are unaware of the dangers of prostate cancer, a disease in which mutated cells develop in a gland in the male reproductive system. Compounding this dilemma is the fact that the lack of immediate symptoms tends to create a false sense of security.

That’s why “early detection and intervention of progressive prostate cancer may help decrease the 40,000 prostate cancer–related deaths each year,” said Bahn, who is internationally recognized as one of the world’s leading practitioners in the study and treatment of prostate cancer. “Treated in its early stages, prostate cancer is highly survivable.”

Possible Causes
While we still don’t know exactly what causes prostate cancer, researchers have found some risk factors and are trying to learn just how these factors cause prostate cells to become cancerous, according to the American Cancer Society’s detailed guide on the disease.

On a basic level, prostate cancer is caused by changes in the DNA of a prostate cancer cell. “During the past few years, scientists have made great progress in understanding how certain changes in DNA can cause normal prostate cells to grow abnormally and form cancers,” states a section on the American Cancer Society’s website entitled, Do We Know What Causes Prostate Cancer?

Researchers have found inherited DNA changes in certain genes may cause about 5 to 10 percent of prostate cancers. Other DNA mutations may be acquired during a man's lifetime.

“Most DNA mutations related to prostate cancer seem to develop during a man's life rather than having been inherited,” states the American Cancer Society. “Every time a cell prepares to divide into 2 new cells, it must copy its DNA. This process is not perfect, and sometimes errors occur, leaving the flawed DNA in the new cell.”

The development of prostate cancer may also be linked to increased levels of certain hormones. For instance, high levels of androgens (male hormones, such as testosterone) promote prostate cell growth, and may contribute to prostate cancer risk in some men.

Other recent studies have found that inflammation may contribute to prostate cancer, with one theory suggesting that inflammation may lead to cell DNA damage, which might in turn push a cell closer to becoming cancerous. However, more research in this area is needed.

Early Detection
With the popularity of early cancer screening with a simple blood test known as the PSA — prostate specific antigen — there has been significant increase in cancer detection, Bahn said. However, the potential danger of prostate cancer is late detection, with cancer spread to bones and lymph nodes, which will lead to painful death.

“Unfortunately, prostate cancer is a silent killer,” said Bahn, whose special areas of interest are the early detection and staging of prostate cancer using color-Doppler ultrasound with tissue harmonics.

“The longer prostate cancer is ignored, the greater the chance that it will spread, first locally to tissues around the prostate, then to other parts of the body, such as lymph nodes, bones, liver and lungs,” he said. “If cancers are detected due to symptoms such as pain and urinary obstructive signs, these are usually a late detection and have poor outcome.”

With that, he recommends an annual PSA for every man age 50 or older, along with a digital rectal examination — DRE — as a part of a yearly physical examination. “If one has a family history of prostate cancer, it should be started at the age of 40.”

Treatment Options
Traditional and conventional treatment options for prostate cancer include radical prostatectomy — a surgical removal — or radiation therapy. Another option, robotic laparoscopic surgery, is known to alleviate complications and side effects typically related to major surgery.


“In radiation therapy, in addition to external beam therapy, seed implantation became popular, if the patient is a proper candidate,” explained Bahn, who has published many scientific articles relating to the diagnosis and treatment of prostate cancer.

Another treatment called cryotherapy — freezing the prostate using argon gas through needle-like probes via skin punctures — is considered a minimally-invasive procedure. “It is a good compromise between active surveillance (watchful waiting) and radical treatment options (radical surgery, radiation therapy, hormone therapy),” Bahn explained. “Our published data shows good cancer control and high rate of maintaining urinary continence and sexual function with focal therapy.”

Other common treatments include brachytherapy, which is a form of radiation in which tiny pellets containing radioactive material are implanted directly into the tumor-containing prostate, usually under ultrasound guidance. Another option called hormone deprivation therapy uses medications to suppress male hormone production from the body, based on the fact that the male hormone androgen is responsible for tumor growth.

“We believe that a multidisciplinary and multi-team approach allows patients to have a full spectrum of knowledge and a complete understanding of the disease and the available treatment options,” Bahn said. “At each step of the treatment process, we strive to inform our patients in a way that alleviates the fear and anxiety often associated with prostate cancer.”

Ongoing Search for a Cure
Unfortunately, there is no panacea in prostate cancer treatment at this time. As a result, “the prostate should be carefully analyzed by color-Doppler transrectal ultrasound to further define the exact location and extent of the disease,” said Bahn, who is considered a pioneer in color-Doppler ultrasound as well as cryoablation therapy.

It may also be necessary for a patient to undergo other imaging studies, such as a CT, Bone Scan or MRI, to complete the investigation. “This is the only logical way to make a well-informed and educated decision as to treatment.”

Immune therapy and gene therapy trials are now underway, and there are also a few new drugs under investigation.

“The Prostate Institute of America is involved with multiple clinical trials,” Bahn said. “The most important trial underway is tumor immune therapy — that is cryotherapy with immune stimulation that works like a vaccine. We have FDA approval for this trial and are currently recruiting candidates.”

Ultimately, the mission of the Prostate Institute of America is to empower patients by noting the importance of early detection, and assisting them in making decisions for their care by providing the best possible information regarding their individual situation. “This approach allows the patient to have a full spectrum of knowledge and a complete understanding of the disease and treatment,” Bahn said.

For more information about the Prostate Institute of America, visit www.pioa.org.
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